Individual
BRIAN KENNETH WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3485 INDEPENDENCE DR, HOMEWOOD, AL 35209-5603
(205) 930-0920
(205) 445-0115
Mailing address
3485 INDEPENDENCE DR, HOMEWOOD, AL 35209-5603
(205) 930-0920
(205) 445-0115
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
23172
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0366100001
CIGNA GOVERNMENT SERVICES PTAN
AL
05
—
133484
—
AL
01
—
511-18907
BLUE CROSS AND BLUE SHIELD OF ALABAMA
AL
01
—
511-20057
BLUE CROSS AND BLUE SHIELD OF ALABAMA
AL
Enumeration date
05/19/2006
Last updated
11/24/2014
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